Dorsal Barton fracture is a variation of dorsal radiocarpal dislocation: a clinical study. (December 2019)

• Record Type: Journal Article
• Authors: Bhashyam, Abhiram R.; Fernandez, Diego L.; Fernandez dell'Oca, Alberto; Jupiter, Jesse B.
• Is Part Of: Journal of hand surgery. Volume 44:Number 10(2019)
• Page Start: 1065
• Page End: 1071
• Publication Date: 2019-12
• Subjects: Distal radius -- musculoskeletal trauma -- Barton fracture -- radiocarpal fracture dislocation; 617.575059
• DOI: 10.1177/1753193419872639
• Languages: English
• ISSNs: 1753-1934

Abstract

Dorsal Barton fractures may be better described as variants of dorsal radiocarpal dislocations. We aimed to better characterize these fractures by reviewing 111 patients in the ICUC® dataset who had a dorsally displaced, intra-articular distal radius fracture. We identified 13 patients with a dorsal Barton fracture on radiographs (dorsal articular margin fracture with radiocarpal subluxation and intact volar cortex). All patients with a dorsal Barton fracture had radial styloid involvement and volar cortical disruption that was subsequently identified on three-dimensional CT. Based on three-dimensional CT and intra-operative findings, none of the patients had classically described dorsal Barton fractures. All patients were treated using a volar exposure. A volar capsular tear was identified intra-operatively in three patients and the volar capsule repaired. This series supports the contention that dorsal Barton fractures are better characterized and treated as a variation of a dorsal radiocarpal dislocation. Level of evidence: IV